DR. GARY S. SIMON M.D.
NPI 1467440107
Orthopaedic Surgery in Austell, GA

Q: What is Gary Simon's NPI number?

The NPI number for Gary Simon is 1467440107. It was assigned to this individual provider in the NPPES registry on October 6, 2005.

Q: What is Gary Simon's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Gary Simon was last updated on February 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 06, 2005PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106(770) 944-1100(770) 944-6469 Get Directions Write a Review

NPPES record last updated: February 5, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Gary S. Simon M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GARY S. SIMON M.D. (NPI 1467440107) is an individual orthopaedic surgery provider in Austell, Georgia, licensed in Georgia (040235) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of State University Of New York Downstate Medical Center (1988).

NPPES Registry Identity

NPI1467440107

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. GARY S. SIMONCredential: M.D.

Location Address2041 MESA VALLEY WAY, SUITE 100Austell, GA 30106-8157

Mailing Address2041 Mesa Valley Way, Suite 100Austell, GA 30106-8157 · (770) 944-1100 · Fax (770) 944-6469

Phone(770) 944-1100

Fax(770) 944-6469

Sole ProprietorNo

Medical School CMSState University Of New York Downstate Medical CenterGraduated 1988

Enumeration DateOctober 6, 2005

Last NPPES UpdateFebruary 5, 2009

✔ NPI 1467440107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in GA · 040235

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

2041 MESA VALLEY WAY, Austell, GA 30106

Open in Google Maps ↗

Other Identifiers 6

Medicare PIN20BBDQKGA

Medicaid000666311IGA

Medicare UPINF87719GA

Medicaid000666311CGA

Medicaid000666311GGA

Medicaid000666311HGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gary S. Simon M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052470630

PECOS Enrollment IDI20081111000854

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gary Simon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Resurgens, LLC

7.1 mi

Orthopaedic Surgery

4441 ATLANTA RD SE STE 207
Smyrna, GA 30080

Reassigned Medicare billing, Georgia enrollment
223 clinicians in this Medicare group

NPI 1821511676 (770) 423-2180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg J7332

Triluron is a treatment involving injections of a substance called hyaluronan into your joints. It helps to lubricate and cushion the joint, which can reduce pain and improve movement, especially in conditions like osteoarthritis. Each injection contains 1 mg of hyaluronan.

3,661 services39 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

653 services341 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

607 services383 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

282 services208 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

239 services180 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

137 services112 patients

Injection, methylprednisolone acetate, 80 mg J1040

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

122 services93 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

104 services104 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

35 services33 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

33 services32 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

24 services24 patients

X-ray of shoulder, 1 view 73020

An X-ray of the shoulder, 1 view, is a quick, painless test that produces images of the bones and tissues within your shoulder. It helps diagnose conditions such as fractures, infections, or arthritis. You'll be positioned to capture the best view, then a small dose of radiation creates the image.

24 services24 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 patients

Repair of shoulder rotator cuff using an endoscope 29827

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

14 services14 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

14 services13 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

13 services13 patients

Shaving of part of shoulder bone and repair of ligament using an endoscope 29826

This procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110042

Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110143

Location3950 Austell RdAustell, GA 30106 · Cobb County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred

7%580 patients1/55-star benchmark: 95%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

95%5,220 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

83%996 patients2/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

38%171 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

97%1,482 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

52%2,901 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

19%2,589 patients1/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 98% · 792 patients

Patients tobacco: 11% · 83 patients

87%792 patients4/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

88%2,901 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

7%2,901 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

46%2,901 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

4 suppliers12 claims12 services$93.54 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JEFFREY N HAIRSTON PA-C

Physician Assistant (Surgical)

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (770) 944-1100

DR. RAFAEL V. URRUTIA JR. M.D.

Orthopaedic Surgery

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (770) 944-1100

RESURGENS, LLC

Orthopaedic Surgery

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (770) 944-1100

MS. SUSAN H KIRBY NP-C

Nurse Practitioner

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (770) 944-1100

NADIA BRIANNA WRIGHT

Physician Assistant

2041 MESA VALLEY WAY
AUSTELL, GA 30106

Cobb County (770) 944-1100

KENNETH C. HOLBROOK PA

Physician Assistant

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (770) 944-1100

JACQUELINE M. SUGGS PTA

Physical Therapy Assistant

2041 MESA VALLEY WAY, SUITE 100
AUSTELL, GA 30106

Cobb County (678) 309-8159

EAST WEST SURGERY CENTER LP

Clinic/Center (Ambulatory Surgical)

2041 MESA VALLEY WAY, STE 125
AUSTELL, GA 30106

Cobb County (678) 309-8100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Simon's NPI number?

The NPI number for Gary Simon is 1467440107. It was assigned to this individual provider in the NPPES registry on October 6, 2005.

Where is Gary Simon located?

Gary Simon practices at 2041 Mesa Valley Way Suite 100, Austell, GA 30106. The listed phone number is (770) 944-1100.

What is Gary Simon's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Gary Simon enrolled in Medicare?

Yes. Gary Simon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gary Simon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Simon reassigns Medicare benefits to Resurgens, LLC (Smyrna, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gary Simon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gary Simon accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Gary Simon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gary Simon affiliated with any hospitals?

According to CMS data, Gary Simon is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center and Wellstar Cobb Medical Center.

When was this NPI record last updated?

The NPPES record for Gary Simon was last updated on February 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.